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A.1 The Health Protection Agency (HPA) estimates that there were 53,000 adults living with HIV at the end of 2003, of whom 14,300 (27%) were unaware of their infection.¹

A.2 As of the end of 2004, a total of 68,556 people have been diagnosed with HIV in the UK.²

A.3 As of the end of 2004, there have been 21,010 diagnoses of AIDS in the UK. It is known that at least 13,082 of these people have died. It should be noted that the difference between these figures does not provide a very accurate estimate of the number of people living with AIDS in the UK: the figure will inevitably include some people who have moved abroad after diagnosis as well as some records belonging to the same person which have not been successfully matched.³

A.4 People in the 25-34 age group have accounted for 45% of all HIV diagnoses in the UK.⁴

A.5 At the end of 2003, an estimated 53,000 adults were living with HIV. Of the 50,500 (95%) who were probably infected through sexual contact, women totalled 15,100 (30%).¹

The male to female ratio of HIV diagnoses made before 1989 was more than 10 to 1, whereas in 2003 the ratio for new diagnoses was 5:4.⁵

A.6 At the end of 2004, it was reported that 50% of infections had occurred in men having sex with men, 39% through heterosexual sex, 6% through injecting drug use, 2% from mother to child and 3% through blood/tissue transfer or blood factor.

Each year until 1999, there were more new HIV diagnoses in men who have sex with men than in any other group. Since then, heterosexual contact has been the major route of infection in the UK, rising to 66% of new diagnoses in 2003. ⁶

A.7 The HPA estimates that a total of 1,225 HIV-infected children have been born to infected mothers as of the end of 2004. There were 52 such births in 2002-03.⁷

A.8 As of the end of 2004, 57% of all UK HIV diagnoses have been made in London. There have been 63,156 diagnoses in England, 4,016 in Scotland, 968 in Wales and 335 in Northern Ireland.⁸

A.9 According to SOPHID data⁹, there were 23,031 people accessing anti-retroviral therapy in England, Wales and Northern Ireland in 2003. More than 97% of these people received at least three types of drug.

A.10 The British HIV Association's (BHIVA) data from their 2001-02 national audit includes a breakdown of the ethnic and gender differences in those receiving treatment.¹⁰ The audit analysed 2,044 patients from 146 centres across the UK. 73% of patients were male, 27% were female. 68% were white and 25% were black African. 44% of patients had acquired their infection heterosexually whilst 45% had acquired it gay or bisexually. 3% of infections were acquired through IV drug use.

A.11 According to the National Association of NHS Providers of AIDS Care and Treatment (PACT), the cost of managing a patient with HIV is £15,000 per year. The total cost of treatment and care in 2002-03 was estimated to be £345 million.¹¹

In 2000 it was estimated that the average lifetime treatment cost for an HIV-positive person was between £135,000 and £181,000.¹² The HPA stated in 2004 that each HIV infection prevented saves between £500,000 and £1 million over a lifetime.¹

A.12 Since 2000, when someone in the UK is diagnosed as being HIV positive, a report is made to the Health Protection Agency (HPA) which includes the following data :

• If in the UK temporarily, country of usual residence
• Country of birth
• Ethnicity
• Year of arrival in the UK (If country of birth outside the UK)
• Whether the patient was presumed to be infected in the UK
• How infection was presumed to have occurred

A.13 The main place where information is published is the HPA quarterly report. The HPA produce quarterly statistical tables. In addition to this a monthly report is published which sometimes contains more specific information. See http://www.hpa.org.uk/infections/topics_az/hiv_and_sti/hiv/epidemiology/introduction.htm.

A.14 Of the 4,239 people who were born outside the UK and were diagnosed HIV positive in the UK between 2000 and 2002, it is not known how many should be paying for NHS treatment. Anyone who has been living in the UK for more than 12 months automatically qualifies for free health care. Anyone who has been in the UK for less than 12 months may qualify for free care, based on the NHS regulations.

A.15 Between 2000 and 2002, 12,312 people were diagnosed as being HIV positive. Of these, their country of birth was reported for 6,484. Of these 6,484 people, 4,239 were born outside the UK.¹³

A.16 This information is collected, but is not published.

A.17 Yes. Health tourism has always existed, as a result of inequalities between the health services of different areas and different countries. This means that people sometimes have to travel to find better or cheaper treatment. Some people may come to the UK for treatment, others may leave the UK and go elsewhere for treatment. HIV is no different from any other disease in this respect.

New guidelines are being issued by the UK government, however, to prevent treatment being given to failed asylum seekers, amongst others. The government wishes to deny help to people on the basis of their immigration status, and has set up a panel of experts to devise a plan to effect these changes¹⁴. Denial of treatment to many of the people in these situations, especially if they are then deported, is effectively a death sentence, and the specialists who have been asked to produce the plans have refused to do so, saying it is 'morally repugnant' and 'racist and profoundly unethical'.¹⁵

Ironically, the government is making efforts to supply freely the drugs to many people in their native countries who would be denied them in this country.

A.18 This data is not published. We do know the presumed countries of infection for people with heterosexually-acquired HIV diagnosed in the UK, which are shown in the table below. This does not necessarily mean that these people come from these countries - just that they were infected in them. The list includes not only high-prevalence African countries, but also popular holiday destinations.¹⁶

A.19 Some may. But a recent survey¹⁷ has indicated that people living in the UK who have HIV and do not come from the UK have, on average, been living in the UK for 5 years and 1 month. More then half had been diagnosed with HIV three years ago or less. This means that most people in the UK who have HIV and do not come from the UK were unaware of their HIV status when they arrived in this country.

A.20 Yes. There is a list of notifiable diseases for which anyone, regardless of their legal status, will get free NHS treatment. This is intended to prevent the spread of epidemics of infectious diseases. HIV is not on the list, but the list does include hepatitis.

A.21 In 2003, 6,932 diagnoses of HIV were made in the UK. Among the 5,732 whose ethnicity is known, 33% were white, 58% black-African, 4% black-Caribbean and 5% of other races.¹⁸

A.22 No. There are certain 'notifiable diseases' which are those for which a person will always receive treatment in the UK regardless of the person's legal status, in order to prevent the rapid spread of epidemics. HIV, however is not on the notifiable diseases list. If a woman has no legal right to be in the UK - if she has overstayed a visa or is an illegal immigrant, then she will only receive medication to stop her baby being born HIV+ if doctors decide it is an 'emergency'. In some hospitals doctors will see this as an emergency, and in others they will not. Doctors are being urged to follow official guidelines, which means in some circumstances not administering drugs to prevent mother-to-child transmission of HIV.